Osteoporosis is the underlying cause of more than 1.5 million fractures a year. This is about 300,000 hip fractures, 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures in other areas. The estimated cost to the nation is over $1.4 billion.

Because osteoporosis has no symptoms, people may not be aware they have it until they fall. A simple everyday movement like picking up something heavy may cause a broken bone or a fall in a store causing a broken hip may be the first symptom. Falls are dangerous to those who have fragile, weak bones. A bone may break depending on the fall itself, its force (how hard a person lands) and direction or angle of the fall, and bone fragility. Prevention of falls is very important for people with osteoporosis. Reducing the force of the fall or falling at a less dangerous angle may prevent fracture. A person is less likely to break a hip if he lands on his hands or grabs something while falling. Falling sideways or straight down is more likely to cause a broken bone than falling backwards.

According to the National Institutes of Health, 90% of all broken hips are associated with osteoporosis. 5-20% of elderly people with hip fractures are more likely to die in the first year after this injury than other elderly people. Most falls happen to women in the afternoon in their own homes.

Factors that increase the risk for falling are muscle weakness around the hip joint, being unsteady on your feet, and taking more than 3 medications

1. Loss of footing or loss of contact between a foot and the ground.

2. Loss of traction. This occurs when the surface is wet, slick, or uneven and a person slips or trips.

3. Vision problems. Bifocals can distort where the ground is making it easy to lose balance and fall. Other vision changes where the person cannot see clearly.

4. Balance problems. Loss of balance can be due to many things. Some of these are described below. Neck stiffness, ankle stiffness, vision and hearing problems, and decreased proprioception (awareness of posture, movement, position, and change in equilibrium) contribute to loss of balance.

5. Medications. Pills for blood pressure, heart, diuretics (water pills), tranquilizers, or anti-depressants may have side effects such as dizziness, confusion, disorientation, or slow reflexes that may cause falling.

6. Slower reflexes. This occurs as one ages making it harder to regain balance after one stumbles or after a sudden body movement.

7. Decreased muscle and fat. Muscle mass decreases if people exercise less and become less active as they age. Body fat that cushions and protests bony areas, such as the hips, may decrease with age. This also can affect the soles of the feet changing the ability to balance.

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1. If wet or slippery, use a walker or cane for more stability and rubber soles for more traction.

2. Observe the floor when out. Polished marble may be slippery or tiled floors uneven.

3. Maybe using delivery services in bad weather will prevent a fall.

4. Keep hands free using a fanny pack or backpack instead of a clutch purse.

5. Check the height of curbs and steps before stepping up or down.

1. Floor safety: Keep things off the floors. Avoid slippery floors due to fallen food and drink. Pay attention to changes in floor levels, such as thresholds and doorways. Wear supportive shoes rather than high heels and floppy slippers that may cause tripping. Avoid throw rugs or make sure small rugs have good skid-proof backing. Keep electrical cords and phone lines out of the way.

2. Bathroom and stair safety: Have plenty of light and tape or paint edges of tape to make them more visible. Use grab bars in tubs, showers and by toilets. Use sturdy chair in shower or automatic lift seat in tub. Use rubber bath mat in shower and tub to reduce slipping.

3. Use portable or cell phones that can be taken from room to room so you don’t have to rush to answer phone. It will also be with you to call in case of an accident. If you live alone arrange for daily contact with a friend or family member. Check into monitoring companies who provide 24-hour service.

4. Keep flashlights handy in case of power outages. Be able to turn lights on from doorway. Use more higher watt bulbs to light walking and working areas. Use voice or sound-activated lamps (Clapper) or touch lamps.

5. Don’t use a step stool, but if you must make sure it is a sturdy one. Have enough of your medications on hand. Assess your medications regularly with a pharmacist or doctor to see if they are increasing your risk of falling.

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If you have become frail, check with your doctor before starting exercises. To avoid falls it helps to improve balance, know how to reduce the impact of a fall, and do weight-bearing exercises. How to reduce the impact of a fall was mentioned earlier.

1. Holding onto the back of a chair or counter top, practice standing on one leg at a time for a minute. Gradually increase the time. On both legs, close eyes and hold on to something stable. Then with eyes still closed try balancing without holding onto anything. Stand on both legs before graduating to one leg with eyes closed.

2. Again, holding on to a chair, stand on the toes for a count of 10. Now rock back to balance on the heels for a count of 10. Repeat. This also helps to make your ankles less stiff and more flexible.

3. Holding on to the back of a chair, circle the hips to the left and then the right, but try not to move the shoulders or feet. Do this 5 times.

4. While watching television (during the commercials?) write the whole alphabet in script in the air with the right foot and then the left. This helps keep the ankles flexible. Flexible ankles help prevent falls, especially when walking on uneven surfaces.

Weight-bearing exercises work against gravity and should be done 3 times a week. They include walking, hiking, jogging, climbing stairs, tennis, and dancing. Resistance exercises should also be done 3 times a week. They include the use of weights and weight machines found at gyms and health clubs.

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